Experienced claims professional with 18 years of experience managing complex workers compensation claims in multiple jurisdictions by working together with employers, injured workers, nurse case managers and attorneys to ensure successful outcomes for all parties while managing overall claim costs.
Overview
23
23
years of professional experience
1
1
Certification
Work History
Senior Resolution Manager
Gallagher Bassett Services Inc.
Orlando, FL
11.2007 - Current
Handling high volume of complex workers compensation claims for 8 jurisdictions in the Southeast region while ensuring a high level of quality.
Investigating workers' compensation claims to determine eligibility and extent of coverage and make compensability determination.
Aggressively managing medical treatment and working collaboratively with nurse case managers, employers and injured workers to ensure optimal outcome for injured workers.
Providing customer service by responding promptly to inquiries from claimants, employers, attorneys and other stakeholders.
Using knowledge and experience of workers compensation laws and trends in order to evaluate financial exposure related to each claim.
Negotiating settlements with claimants in order to achieve a fair resolution of claims.
Collaborating with legal counsel in the development of strategies to resolve claims.
Maintaining timely communication with clients and other stakeholders throughout the life cycle of the claim regarding status updates and resolution options.
Earned promotion to Senior Resolution Manager in 2014 based on my demonstration of high level quality claims handling and excellent client relationships.
Act as a resource and mentor to junior colleagues.
Claims Service Representative
Gallagher Bassett Services Inc.
Orlando, FL
05.2001 - 10.2006
Efficiently handled high volume of medical only workers compensation claims in multiple jurisdictions while providing a high level of customer service.
Maintained accurate records of all claims activities in the database system.
Reviewed progress of outstanding claims to ensure timely resolution.
Claims Assistant
Gallagher Bassett Services Inc.
Orlando, FL
10.2004 - 04.2005
Assisted in the preparation of documents and correspondence for claims processing.
Performed data entry into internal systems to process claims requests.
Answered inquiries from customers regarding their individual claims status.
Processed payments for approved claims within specified time frames.
Education
Bachelor of Arts - Sociology And Anthropology
Truman State University
Kirksville, MO
03-1995
Skills
Complex claims management
Case settlement abilities
Litigation resolution
Effective Communication
Strong technical skills and ability to quickly learn new systems
Certification
Licensed in workers compensation in Florida, Georgia, Alabama, Mississippi, Louisiana, North Carolina, South Carolina and Tennessee.